This invention relates to methods and means for inserting nasal gastric tubes into the stomachs of patients for evacuation of stomach fluids.
Post-surgical patient recovery often necessitates the continuous withdrawal of fluids from the patient' s stomach. This is accomplished by the means of placing the perforated end of a tube within the stomach and applying a suction force to draw fluids out of the stomach and patient through the tube. Since the tube must ordinarily be left in place for a substantial period of time it is highly preferable to have the tube routed through the nasopharynx and nasal passages rather than exit through the mouth of the patient. Extension of the tube out through the mouth would be very discomforting to the patient over an extended period of time due to the gagging and coughing such a position initiates. A tube of size and flexibility to be routed through the nasopharynx, esophagus and into the stomach of a patient is termed a nasal gastric tube.
In positioning a nasal gastric tube within a patient the perforated tube end is first extended into the nose through the nasal passages and nasopharynx to a position adjacent to the larynx. Here the tube must be carefully routed into the esophagus rather than into the trachea in order to approach the stomach. This is a difficult and tedious task with many patients as when their nasopharynx is not smooth but stretched and wrinkled with age, and when the patient is under anesthesia. It thus often occurs that the tube, which is quite flexible in order to follow the body cavities smoothly, enters the trachea instead. When this occurs the tube must be partially withdrawn and attempts remade in guiding the tube into the esophagus. In other cases the tube end becomes lodged in abuttment against the pharynx and begin to double up and fold into the mouth. Again attempts must be made to retrieve and re-route the nasal gastric tube into the esophagus.
The just described problems of repeatedly guiding a nasal gastric tube into the esophagus and stomach tends to cause nose bleeding and to traumatize the pharynx. In addition, substantial periods of time are often required in properly locating the nasal gastric tube. As previously stated, the nasal gastric tube must be soft and flexible but these very attributes impede placement.
To overcome these problems there has heretofore been developed several instruments designed to be inserted through the mouth into gripping engagement with the nasal gastric tube located adjacent the pharynx in order to guide it into the esophagus. U.S. Pat. Nos. 3,316,913 and 3,339,552 exemplify such instruments which generally take the form of metal clamps or forceps adapted to grip an end portion of the nasal gastric tube in guiding it into place. The use of forceps however is rather ineffectual since the entrance to the esophagus is located substantially below that area of the pharynx which may be easily visualized through the mouth. The metal forceps may also themselves traumatize the pharynx. In use they must be intermitantly and repeatedly released and moved up to higher portions of the tube and then re-gripped in urging the nasal gastric tube down step by step towards and into the esophagus. With each such relocation of the forceps time passes and the threat of pharynx traumatization increases.
Accordingly, it is a general object of the present invention to provide an improved method for guiding a nasal gastric tube into the esophagus and stomach of a patient for evacuation of stomach fluids.
Another object of the invention is to provide a method of guiding a nasal gastric tube into the esophagus and stomach of a patient without the use of forceps, clamps or the like.
Another general object of the invention is to provide an improved guide for guiding a nasal gastric tube into the esophagus and stomach of a patient.
Yet another object of the invention is to provide a guide of the type described which tends less to traumatize a patient's pharynx in operation than do the guides of the prior art.